Acute treatment of critical vascular stenoses with a bioabsorbable magnesium scaffold in infants with CHDs

2020 ◽  
Vol 30 (4) ◽  
pp. 493-499
Author(s):  
Peter A. Zartner ◽  
Dietmar Schranz ◽  
Nathalie Mini ◽  
Martin B. Schneider ◽  
Katja Schneider
Keyword(s):  
Innominate Vein ◽  
Arterial Stenosis ◽  
Maximum Diameter ◽  
Vein Thrombosis ◽  
Vessel Growth ◽  
Vascular Stenosis ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis ◽  
Stent Material ◽  
Endothelial Tissue

AbstractBackground:Post-operative severe vascular stenosis and proliferating endothelial tissue lead to severe circulatory disorders and impair organ perfusion. Bioabsorbable magnesium scaffolds may help to overcome these obstructions without leaving obstructing stent material. We analyse their role in the treatment of vascular stenosis in infants.Methods:Since 2016, 15 magnesium scaffolds with a diameter of 3.5 mm were implanted in 9 patients aged 15 days to 7.6 years. Eight scaffolds were implanted in pulmonary venous restenoses, five in pulmonary arterial stenosis including one in-stent stenosis, one into a stenotic brachiocephalic artery, and one in a recurrent innominate vein thrombosis.Results:All patients clinically improved after the implantation of a scaffold. The magnesium scaffolds lost integrity after 30–48 days (mean 42 days). The innominate vein thrombosed early, while all other vessels remained open. Two patients died after 1.3 and 14 weeks not related to the scaffolds. Five patients needed further balloon dilations or stent implantations after the scaffold had fractured. At first recatheterisation after in mean 2.5 months, the mean minimum/maximum diameter in relation to the scaffold’s original diameter was 89%/99% in the arterial implantations (n = 6) and 66%/77% in the pulmonary venous implantations.Conclusions:The magnesium scaffolds can be used as a bridging solution to treat severe vascular stenosis in different locations. Restenosis can occur after degradation and make further interventions necessary, but neither vessel growth nor further interventions are hindered by stent material. Larger diameters may improve therapeutic options.

Arteriohepatic Dysplasia: Association of Liver Disease with Pulmonary Arterial Stenosis as Well as Facial and Skeletal Abnormalities

PEDIATRICS ◽  
1980 ◽  
Vol 66 (6) ◽  
pp. 876-883
Author(s):  
Solomon E. Levin ◽  
Paniyotis Zarvos ◽  
Selwyn Milner ◽  
Arthur Schmaman
Keyword(s):  
Liver Disease ◽  
Coronary Artery ◽  
Clinical Features ◽  
Arterial Stenosis ◽  
Viral Etiology ◽  
Congenital Rubella ◽  
Arteriohepatic Dysplasia ◽  
Pulmonary Arterial ◽  
The Right ◽  
Pulmonary Arterial Stenosis

The clinical features and course of five children with the recently described syndrome of arteriohepatic dysplasia are presented. All had bilateral pulmonary arterial stenosis, proven at cardiac catheterization, as well as associated liver disease of varying severity. In one of the fatal cases, a hitherto undescribed anomaly was found—stenosis of the right coronary artery ostium. A viral etiology, eg, the congenital rubella syndrome, was considered most likely, but detailed investigations proved to be negative.

Experimental studies on the implantation of intravascular stents in puppies—potential use for aortic coarctation and pulmonary arterial stenosis

1994 ◽  
Vol 4 (4) ◽  
pp. 366-372 ◽  
Author(s):  
Toshihiro Ino ◽  
Shinjiro Shimazaki ◽  
Keijiro Yabuta ◽  
Ryozo Okada
Keyword(s):  
Aortic Coarctation ◽  
Experimental Studies ◽  
Pulmonary Arteries ◽  
Arterial Stenosis ◽  
Inferior Caval Vein ◽  
Major Disadvantage ◽  
Intravascular Stents ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis

AbstractWe have investigated angiographically and histologically the vascular response to implantation of intravascular stents in normal puppies. Eight balloon-expandable stents were placed in six mongrel puppies (weight 6.4–10.5 kg) under anesthesia. Four stents were successfully placed in the pulmonary arteries and three in the aorta. In one case, the strut of the stent was hooked by a leaflet of the tricuspid valve at the time of placement and eventually had to be implanted in the inferior caval vein. Two puppies died, one from bleeding from the femoral artery and the other from thrombotic obstruction at the superior mesenteric artery, both after successful implantation. The former was due to repeat arterial puncture and the latter wasdue to failure to use aspirin. Angiographic studies showed satisfactory opacities of the branch arteries in all but one puppy. The diameter of the arteries prior to implantation was 7.5±1.5 mm. The diameters at the middle of the stents immediately after implantation and during the period of follow-up were 6.9±1.7mm and 6.9±2.1 mm, respectively. Histologic studies revealed that neogenic endothelial layers of 30 to 40 pm in thickness had formed over the struts of the stent without formation of thrombusthree weeks after implantation. Scanning electron microscopy revealed that the endothelial cells of the neoendothelial layer had almost identical characteristics to those of normal arteries. These results indicate that clinical application of this stent is feasible but that use of anticoagulants is mandatory during and after implantation in the treatment of selected patients with aortic coarctation or pulmonary arterial stenosis. Relative progression of stenosis may occur, however, and the inability for re-expansion is a major disadvantage of this stent.

scholarly journals Isolated pulmonary arterial stenosis caused by Takayasu's arteritis in an elderly male

2008 ◽  
Vol 51 (3) ◽  
pp. 196-200 ◽  
Author(s):  
Yusuke Fukuda ◽  
Kazuyuki Shirai ◽  
Yosuke Takamiya ◽  
Miller Nathan ◽  
Takahiro Mito ◽  
...  
Keyword(s):  
Takayasu’S Arteritis ◽  
Arterial Stenosis ◽  
Takayasu's Arteritis ◽  
Elderly Male ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis

Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis

1992 ◽  
Vol 69 (17) ◽  
pp. 1467-1470 ◽  
Author(s):  
Martin C.K. Hosking ◽  
Constantin Thomaidis ◽  
Robert Hamilton ◽  
Patricia E. Burrows ◽  
Robert M. Freedom ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Clinical Impact ◽  
Arterial Stenosis ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis

scholarly journals Exercise Training Attenuates Right Ventricular Remodeling in Rats with Pulmonary Arterial Stenosis

2016 ◽  
Vol 7 ◽  
Author(s):  
Brunno Lemes de Melo ◽  
Stella S. Vieira ◽  
Ednei L. Antônio ◽  
Luís F. N. dos Santos ◽  
Leslie A. Portes ◽  
...  
Keyword(s):  
Exercise Training ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Arterial Stenosis ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis ◽  
Right Ventricular Remodeling

A case of William's syndrome associated peripheral pulmonary arterial stenosis

1988 ◽  
Vol 24 (3) ◽  
pp. 485
Author(s):  
K H Jung ◽  
M S Hwang ◽  
S Y Kim ◽  
J C Chang ◽  
B H Park
Keyword(s):  
Arterial Stenosis ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis

Letters to the Editor

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 464-465
Author(s):  
Solomon E. Levin
Keyword(s):  
Cardiac Catheterization ◽  
Clinical Evidence ◽  
Pulmonary Stenosis ◽  
Arterial Stenosis ◽  
Letters To The Editor ◽  
Genetic Origin ◽  
Arteriohepatic Dysplasia ◽  
Pulmonary Arterial ◽  
Pulmonary Arterial Stenosis ◽  
Peripheral Pulmonary Stenosis

The comments of Drs Riely, Rosenfield, and Cotlier are interesting, especially in relation to the abnormal eye findings and additional skeletal anomalies they have reported in cases of arteriohepatic dysplasia.1 Their contention that the syndrome is likely to be of genetic origin receives support from my own observations on two families seen subsequent to submission of our article for publication.2 In one family there were two siblings, a boy aged 5 years 3 months with significant pulmonary arterial stenosis documented at cardiac catheterization, and his younger sister, with clinical evidence of mild peripheral pulmonary stenosis.

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